Race, Discrimination, and Cardiovascular Disease

Disparities in Cardiovascular Mortality Between Black and White Adults in the United States, 1999 to 2019

“…24,39,40 Even among those with adequate access to health care, the implicit and explicit biases of health care providers and systems may lead to lower-quality care (ie, cardiovascular disease risk assessment, screening, 41,42 and treatment recommendations). 35,43,44 We observed marked geographic variation in cardiovascular mortality in the United States. For example, the Northeast region had the lowest overall mortality rates for Black women and men, which may be related to regional factors including a higher degree of physical activity, more concentrated medical resources, and ease of transportation.…”

“…Numerous studies have found that poverty, 33 food insecurity, 34 chronic stress, and other environmental factors adversely affect the cardiovascular health of Black individuals. Black women experience high levels of racism, sexism, and discrimination in comparison with other groups, 10,35 and the mass incarceration of Black men across the country has created an inherent barrier to their health, having already been linked to a higher risk of cardiovascular disease. 7 Beyond social risk factors, Black adults continue to face worse access to health care and numerous barriers towards access to equitable and timely cardiovascular care, 35,36 and are also more likely to receive care at lower-quality practices and hospitals, 37,38 compared with their White counterparts.…”

Putting Risk Factors in Context: an Anti-Oppression Approach

“…39 Risk is due to combination of factors, including family history, genetic ancestry, and racismrelated stress. 11,39,40 Alcoholism Indigenous Canadians are more likely to have an alcohol abuse disorder.…”

“…9 However, when risk factors associated with demographics are directly applied in a clinical setting, it results in stereotyping, assumptions, misdiagnosis, reduced access to healthcare, and poorer health outcomes. 2,3,[10][11][12][13][14][15][16][17][18] For example, risk factors presented out of context prime clinicians to view sickle cell disease as affecting only Black patients rather than as common in populations at risk for malaria or result in lower rates of cervical cancer screening amongst lesbian and bisexual women. 2,[19][20][21] Without an understanding of the structural, institutional and interpersonal power dynamics as well as other intersecting factors contributing to the underlying causes of health disparities, clinicians risk perpetuating implicit bias and discrimination in their interactions with patients.…”

Medical humanities research showcase: the emergence of a new trans-disciplinary field in a time of precarity

“…There are further analogies to be made in the way that pre-existing respiratory and cardiovascular conditions were presented as individual factors in the men's deaths, even though the effects of structural racism mean that such diseases are disproportionately common in Black American (Brewer and Cooper 2014) and Australian Indigenous communities (Durey and Thompson 2012); this rhetorical strategy mirrors the one Holly Fulton-Babicke examined in media coverage of Eric Garner's death (2018). COVID-19 health advice in Australia has highlighted the effect of race on pandemic vulnerability, putting racist health disparities between white and Indigenous communities in daily view.…”